Relationship between hyperhomocysteinemia and the risk of stroke recurrence:a Meta⁃analysis
Bibliographic record
Abstract
ObjectiveTo explore the relationship between hyperhomocysteinemia and the risk of stroke recurrence，so as to provide the basis for related clinical decision⁃making.MethodsThe prospective cohort studies on the relationship between hyperhomocysteinemia and the risk of stroke recurrence were retrieved from PubMed，EMbase，The Cochrane Library，Web of Science，Wanfang Data，China Biology Medicine disc（CBM），China National Knowledge Infrastructure（CNKI），and VIP Database from the establishment of the databases to January 31 2020.According to the inclusion and exclusion criteria，two researchers independently screened the literature，extracted the data，used the Newcastle⁃Ottawa scale（NOS）for quality evaluation，and used RevMan5.3 and Stata11.0 software for meta⁃analysis on the data.ResultsA total of 22 prospective cohort studies were included，involving 26 400 patients with stroke.Relationship between hyperhomocysteinemia and the risk of stroke recurrence：adjusted OR values combination showed that hyperhomocysteinemia increased the risk of stroke recurrence［OR=1.27，95%CI（1.10，1.46），P=0.000 9］.The combination of unadjusted OR values showed that hyperhomocysteinemia increased the risk of stroke recurrence［OR=1.24，95%CI（1.15，1.33），P<0.000 01］.Relationship between hyperhomocysteinemia and the risk of stroke recurrence in different follow⁃up periods：adjusted OR values combination showed that hyperhomocysteinemia increased the risk of stroke recurrence during a follow⁃up period of 1 to 3 years［OR=1.30，95%CI（1.04，1.61），P=0.02］；and hyperhomocysteinemia during the follow⁃up period>3 years increased the risk of stroke recurrence［OR=1.21，95%CI（1.02，1.44），P=0.03］.The combination of unadjusted OR values showed that hyperhomocysteinemia increased the risk of stroke recurrence during the follow⁃up period of less than 1 year［OR=2.45，95%CI（1.20，4.97），P=0.01］；and hyperhomocysteinemia increased the risk of stroke recurrence during a follow⁃up period of 1 to 3 years［OR=1.39，95%CI（1.21，1.58），P<0.000 01］；hyperhomocysteinemia increased the risk of stroke recurrence during the follow⁃up period>3 years［OR=1.18，95%CI（1.09，1.27），P<0.000 1］.Relationship between hyperhomocysteinemia and the risk of stroke recurrence or different stroke types：the adjusted OR value showed that hyperhomocysteinemia increased the risk of recurrence of large artery atherosclerotic stroke［OR=1.09，95%CI（1.03，1.16），P=0.006］；hyperhomocysteinemia did not increase the risk of large artery atherosclerotic stroke［OR=0.69，95%CI（0.31，1.53），P=0.37］.The unadjusted OR values combination showed that hyperhomocysteinemia did not increase the risk of recurrence of atherosclerotic stroke in large arteries［OR=1.33，95%CI（0.92，1.92），P=0.12］；hyperhomocysteinemia did not increase the risk of recurrence of arteriolar occlusive stroke［OR=1.35，95%CI（0.97，1.87），P=0.07］.ConclusionsCurrents evidences showed that hurrent evidence shows that Hyperhomocysteinemia might be a risk factor for stroke recurrence.It was suggested that clinical doctors and nurses should routinely detect the level of hyperhomocysteinemia in stroke management and take effective intervention measures to improve the prognosis of stroke patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.020 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.048 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".